20 of 12 terms selected
Hank's Fish Store, Inc. is a small company with just 15 employees located in
Florida. Hank, the store owner, has provided excellent health benefits to the
store's workforce. William, one of the store's long-time employees, will soon be
reaching age 65 and eligible for Medicare. William is in good health. He intends
to remain an active full-time employee, working several years after becoming
eligible for Medicare. What type(s) of retiree health benefit will Hank's Fish Store
be able to offer William? a.Hank's can only offer the same plan it provides to its
employees who are not Medicare eligible. b.A MSA plan that includes
prescription drug coverage. c.A PACE plan. d.Hank's can continue to offer
William the same employee health benefit plan, or, if William enrolls in Medicare
Part B, it can enroll him in a Medicare Advantage plan that is offered to the
public.
d.Hank's can continue to offer William the same employee health benefit plan, or,
if William enrolls in Medicare Part B, it can enroll him in a Medicare Advantage
plan that is offered to the public.
Dr. Elizabeth Brennan does not contract with the ABC PFFS plan but accepts the
plan's terms and conditions for payment. Mary Rodgers sees Dr. Brennan for
treatment. How much may Dr. Brennan charge? a.Dr. Brennan can charge Mary
Rogers no more than the cost sharing specified in the PFFS plan's terms and
condition of payment which may include balance billing up to 15%of the Medicare
rate. b.Dr. Brennan can charge the beneficiary the same cost-sharing as Original
Medicare as long as she sends the claim to Medicare and not the plan. c.Dr.
Brennan can charge Mary Rodgers more than the cost sharing specified in the
PFFS plan's terms and conditions as long as she treats all beneficiaries the
same. d.Dr. Brennan can charge Mary Rodgers no more than the cost sharing
specified in the PFFS plan's terms and conditions of payment which may include
balance billing up to 25% of the Medicare rate.
, a.Dr. Brennan can charge Mary Rogers no more than the cost sharing specified
in the PFFS plan's terms and condition of payment which may include balance
billing up to 15%of the Medicare rate.
Mrs. Wang wants to know generally how the benefits under Original Medicare
might compare to the benefits package of a Medicare Advantage Plan before she
starts looking at specific plans. What could you tell her? a.MA Plans may offer
extra benefits that Original Medicare does not offer such as vision, hearing, and
dental services. It must include a maximum out-of-pocket limit on Part A and Part
B services. b.All MA Plans offer cost-sharing that is lower than Original Medicare
for all Part A and Part B covered services, but the maximum out-of-pocket limit is
higher than in Original Medicare. d.MA Plans are not permitted to offer any
benefits beyond those available under the Original Medicare program and must
have the same maximum out-of-pocket limit on Part A and Part B services as
Original FFS Medicare.
a.MA Plans may offer extra benefits that Original Medicare does not offer such as
vision, hearing, and dental services. It must include a maximum out-of-pocket
limit on Part A and Part B services.
Ms. Gibson recently lost her employer group health and drug coverage and now
she wants to enroll in a PPO that does not include drug coverage. What should
you tell her about obtaining drug coverage? a.She can enroll in the PPO, but she
will not be able to purchase a stand-alone Medicare Part D prescription drug
plan. b.She can enroll in the PPO and if she decides that she wants drug
coverage, she will be able to drop her PPO at any time in favor of a Medicare
Advantage plan that includes such drug coverage c.She can enroll in the PPO
and purchase drug coverage through a stand-alone Medicare Part D prescription
drug plan. d.She can enroll in the PPO and purchase drug coverage through a
Medigap plan.
Hank's Fish Store, Inc. is a small company with just 15 employees located in
Florida. Hank, the store owner, has provided excellent health benefits to the
store's workforce. William, one of the store's long-time employees, will soon be
reaching age 65 and eligible for Medicare. William is in good health. He intends
to remain an active full-time employee, working several years after becoming
eligible for Medicare. What type(s) of retiree health benefit will Hank's Fish Store
be able to offer William? a.Hank's can only offer the same plan it provides to its
employees who are not Medicare eligible. b.A MSA plan that includes
prescription drug coverage. c.A PACE plan. d.Hank's can continue to offer
William the same employee health benefit plan, or, if William enrolls in Medicare
Part B, it can enroll him in a Medicare Advantage plan that is offered to the
public.
d.Hank's can continue to offer William the same employee health benefit plan, or,
if William enrolls in Medicare Part B, it can enroll him in a Medicare Advantage
plan that is offered to the public.
Dr. Elizabeth Brennan does not contract with the ABC PFFS plan but accepts the
plan's terms and conditions for payment. Mary Rodgers sees Dr. Brennan for
treatment. How much may Dr. Brennan charge? a.Dr. Brennan can charge Mary
Rogers no more than the cost sharing specified in the PFFS plan's terms and
condition of payment which may include balance billing up to 15%of the Medicare
rate. b.Dr. Brennan can charge the beneficiary the same cost-sharing as Original
Medicare as long as she sends the claim to Medicare and not the plan. c.Dr.
Brennan can charge Mary Rodgers more than the cost sharing specified in the
PFFS plan's terms and conditions as long as she treats all beneficiaries the
same. d.Dr. Brennan can charge Mary Rodgers no more than the cost sharing
specified in the PFFS plan's terms and conditions of payment which may include
balance billing up to 25% of the Medicare rate.
, a.Dr. Brennan can charge Mary Rogers no more than the cost sharing specified
in the PFFS plan's terms and condition of payment which may include balance
billing up to 15%of the Medicare rate.
Mrs. Wang wants to know generally how the benefits under Original Medicare
might compare to the benefits package of a Medicare Advantage Plan before she
starts looking at specific plans. What could you tell her? a.MA Plans may offer
extra benefits that Original Medicare does not offer such as vision, hearing, and
dental services. It must include a maximum out-of-pocket limit on Part A and Part
B services. b.All MA Plans offer cost-sharing that is lower than Original Medicare
for all Part A and Part B covered services, but the maximum out-of-pocket limit is
higher than in Original Medicare. d.MA Plans are not permitted to offer any
benefits beyond those available under the Original Medicare program and must
have the same maximum out-of-pocket limit on Part A and Part B services as
Original FFS Medicare.
a.MA Plans may offer extra benefits that Original Medicare does not offer such as
vision, hearing, and dental services. It must include a maximum out-of-pocket
limit on Part A and Part B services.
Ms. Gibson recently lost her employer group health and drug coverage and now
she wants to enroll in a PPO that does not include drug coverage. What should
you tell her about obtaining drug coverage? a.She can enroll in the PPO, but she
will not be able to purchase a stand-alone Medicare Part D prescription drug
plan. b.She can enroll in the PPO and if she decides that she wants drug
coverage, she will be able to drop her PPO at any time in favor of a Medicare
Advantage plan that includes such drug coverage c.She can enroll in the PPO
and purchase drug coverage through a stand-alone Medicare Part D prescription
drug plan. d.She can enroll in the PPO and purchase drug coverage through a
Medigap plan.
